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Assessment of lymph node metastasis in elderly patients with colorectal cancer by sentinel lymph node identification
1Department of Gastrointestinal Surgery, Qilu Hospital of Shandong University, Jinan 250012, P.R.China.
Purpose:
To identify the sentinel lymph node (SLN) in abdominal lymph node metastases of elderly patients with colorectal cancer using carbon nanoparticles (CN).
Methods:
80 colorectal cancer patients admitted to the affiliated Weihai Second Municipal Hospital of Qingdao University from November 2014 to February 2017 were selected, and divided into the control group (n=40) and the study group (n=40). The control group was treated with surgery, while the study group was administered CN tracer subcutaneously for intraoperative dye positioning; the first to four black-stained lymph nodes were marked as SLN and then radical surgery for CRC followed. Pathological examination of intraoperative specimens was performed to assess SLN metastasis.
Results:
There were no statistically significant differences in the distant metastasis rate and SLN metastasis rate between the two groups (p>0.05). The total number of lymph nodes and the number of micro lymph nodes (<2 mm) in the study group was higher compared with the control group (p<0.05); the ratio of <12 lymph nodes in the study group was lower compared with the control group (p<0.05). In the study group, 8 out of 40 cases had SLN metastasis, the detection rate of SLN using CN was 92.50%, the accuracy rate was 94.59%, the specificity of diagnosis was 87.50%, the false negative rate was 12.50% and the negative predictive value was 21.88%. Νo statistically significant difference was noted in the metastasis rate of black-stained lymph nodes and non-black-stained lymph nodes in the study group (p>0.05). The black-stained rate of micro lymph nodes was higher than the total black-stained rate (p<0.05). Τhe rate of micro lymph node metastasis was lower than that of lymph node metastasis >5mm (p<0.05).
Conclusion:
Preoperative SLN examination can evaluate the abdominal lymph node status in elderly patients with colorectal cancer, which is simple and accurate and can guide the clinical treatment, so it is worthy of popularization and application.
